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目的:探究成纤维细胞生长因子23(FGF23)在终末期肾病患者继发性甲状旁腺功能亢进中的作用机制。方法:选取我院2013年2月-2015年5月期间收治的58例终末期肾病进入血液透析的患者,所有患者均经甲状旁腺CT增强扫描,无增生及结节。按照i PTH值将其分为两组,i PTH>300 pg/m L为观察组,150 pg/m L≤i PHT≤300 pg/m L为对照组,每组29例。患者均予碳酸钙以及活性维生素D3进行治疗。对患者钙、磷、白蛋白、血脂以及FGF23、i PTH、1,25(OH)_2D_3进行检验。结果:治疗后观察组患者FGF23及i PTH均高于对照组,差异具有统计学意义(P<0.05)。观察组血尿素氮、血肌酐与透析前相比明显下降,对照组血尿素氮、血肌酐与透析前相比明显下降,差异有统计学意义(P<0.01);1,25(OH)_2D_3以及血白蛋白水平是影响Log FGF23的独立影响因素。结论:FGF23在终末期肾病患者继发性甲状旁腺功能亢进发病中发生作用,可作用临床诊断依据。
Objective: To investigate the mechanism of fibroblast growth factor 23 (FGF23) in secondary hyperparathyroidism in patients with end-stage renal disease. Methods: Fifty-eight patients with end-stage renal disease admitted to our hospital from February 2013 to May 2015 were enrolled in hemodialysis patients. All patients underwent enhanced parathyroid scan with no hyperplasia and nodules. According to the value of i PTH, they were divided into two groups: i PTH> 300 pg / m L for the observation group and 150 pg / m L≤i PHT≤300 pg / m L for the control group, with 29 in each group. Patients were treated with calcium carbonate and vitamin D3. Patients with calcium, phosphorus, albumin, blood lipids and FGF23, i PTH, 1,25 (OH) _2D_3 were tested. Results: After treatment, FGF23 and i PTH in the observation group were higher than those in the control group, the difference was statistically significant (P <0.05). The levels of blood urea nitrogen and serum creatinine in the observation group decreased significantly compared with that before dialysis, while the levels of blood urea nitrogen and serum creatinine in the control group decreased significantly compared with those before dialysis (P <0.01); 1,25 (OH) _2D_3 And serum albumin levels are independent factors affecting Log FGF23. Conclusion: FGF23 plays an important role in the pathogenesis of secondary hyperparathyroidism in patients with end-stage renal disease and can be used as a basis for clinical diagnosis.